Monday, September 30, 2013

Biologic Dentist?

“Are you a biologic dentist?”

In more than 20 years of practice, I had never been asked that question. Last week, two patients asked me this very question. That always grabs my attention.

As the younger dentists in our audience will soon discover, dental stories in the media tend to run in cycles. It seems that every seven years, you’ll get stories about how bad amalgam is. Every 10 years, you’ll hear that someone is developing a vaccine for caries. We recently dealt with stories about how bad dental x-rays are. You get the idea.

Every time one of these stories airs, you’ll find yourself fielding some questions on that particular subject. When two different people asked me the same question I had never heard before, I wondered which news program I had missed.

Biologic dentistry is also referred as holistic or alternative dentistry. I have never referred to myself as a biologic dentist, and I have never claimed to be a holistic dentist. I was very curious as to why people were asking me about this.

Before I go on, let me just say that my blog is not about whether the concept of holistic (biological) dentistry is good or bad. You can decide that for yourself. My goal is to illustrate how I handle such inquiries. You will be asked such questions in your career. The most common variants involve cosmetic and family dentistry. They are different questions, but the same concept.

In answering these inquiries, I simply ask, “What is it that you want done?” I inform the patient that I may just be the dentist they are looking for. Or, I may not.

In this case the patient stated that she had old, broken silver fillings and wanted a dentist who could replace them with white fillings. That sounded simple enough. However, I was the third dentist she had visited. One dentist informed her that he only does silver fillings and the other said that he does both but prefers amalgam. I let the patient know that I haven’t placed a silver filling in about eight years, mostly because people want white teeth. Amalgam fillings are fine by me, but I do not have the ability to make them white. That was perfect for her; she had found her “biologic” dentist.

I have learned to ask what the patient really wants done. I’ve had patients ask me if I was a cosmetic dentist. Upon asking them what they meant, I found that most people wanted a dentist who could do white crowns and fillings. On those rare occasions when patients actually need a full-mouth rehabilitation, I refer to my local prosthodontist. It is just a matter of asking.

Maybe, just maybe, I am a biologic dentist after all.

Andy Alas, DDS

1 comment:

Lilya Horowitz DDS said...

I have made an attempt to inquire what these "holistic" dentists do differently. I think it is a good concept and I understand the appeal to the public since there is a big market in the organic and chemical free sector nowadays.
One thing I try to stress to patients is the composite is NOT chemical free, just because it is white. I know some holistic dentists claim some composites have less emissions than others, still they cannot be much different. Another "difference" with holistic dentistry is using isolation (rubber dam or other means including a high speed suction) to remove old fillings, particularly those containing mercury. I think most of us do this anyway, and we do not label ourselves as special for doing so. It is just good dentistry. I have had patients that are just frustrated with dentistry and are looking for an "all-natural" solution to their problems. I have not found a way to heal cavities without drilling yet but if someone does, please share!!!



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